Weight Watchers

by Julianne Haydel on January 11, 2011

I spent part of last week and yesterday in an agency reviewing clinical records. Prior to that, I reviewed a Joint Commission Complaint for an orthopedic rehabilitation hospital. I am also in the middle of survey hell for a small local hospital. What do all of these projects have in common? A seeming inability of nurses to weigh patients.

The home health had one patient whose weights fluctuated 40 pounds regularly. The JCAHO complaint involved a gentleman who had lost a significant amount of weight. The psych hospital failed to weigh patients for orders for weights existed.

Make no mistake. These are all good clients. The home health agency had multiple nurses getting various patient weights confused resulting in 40 pound differences. The JCAHO complaint involved a patient who received excellent care which was well documented. In fact, the Joint Commission, after reviewing the response told the agency no further action was necessary. The local hospital had already been cited for not following physician orders and the lack of weights gave the surveyors the impression that the hospital simply didn’t care to follow orders as a general rule.

All of these issues took time and money. My services are not free. Writing survey reports and JCAHO reports take staff time that could otherwise be spent tending to patients. And it is so easy to simply weigh patients.

Or is it? Am I missing something? For as long as I have been a nurse, obtaining weights has been an issue. Does anyone have a solution?

I know that when I visit my doctor, I am weighed whether I want to be or not. Even if I stop by to pay a bill or retrieve a sweater I left in the waiting room, a perky little nursette insists on weighing me. In home health, where medication decisions are dependent on weights and hospitalizations happen when we fail to monitor and report weights, we can’t seem to get the patient on a scale.